Collaborating to address infant mortality: lessons learned from the Brownsville action community for health equality.

Background: Brownsville Action Community for Health Equality (BACHE) is a coalition-based, service system change pilot for African American and Puerto Rican women of Brownsville, a community within Brooklyn, New York, with disproportionately high rates of infant mortality.

Objectives: Identify "lessons learned" from the implementation phase of a 5-year pilot project that employs a community-based participatory (CBPR) approach to reducing risk factors for infant mortality.

Methods: Nineteen semi-structured interviews were conducted with BACHE's partners throughout 2010. Sessions were audiotaped and transcribed. Data was incorporated into a framework based on grounded theory and interpreted by project partners.

Results: Lessons learned related to engaging partners, leveraging community resources, dealing with highly structured institutions, measuring progress, and promoting and sustaining system change.

Conclusion: A service system change pilot like BACHE requires: social capital, capable partners, a strong coalition, flexibility of approach, internal champions, systems knowledge, awareness of policy, and strong community involvement.